MEDICARE: DR. MARIA A PROYTCHEVA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	45432	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386644433
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA A PROYTCHEVA M.D.

Provider Business Mailing Address
First Line	:	PO BOX 29681
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85038-9681
Country	:	US
Telephone Number	:	520-874-4135
Fax Number	:	520-874-3480

Provider Business Practice Location Address
First Line	:	1501 N CAMPBELL AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85714
Country	:	US
Telephone Number	:	520-874-4135
Fax Number	:	520-874-3480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	09/07/2012

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